Tubercular Meningitis in Children

Tubercular meningitis (TB meningitis) in children is an inflammation of the meninges caused by tuberculosis. The meninges are the protective coat that covers the brain and spinal cord, also known as the central nervous system (CNS). This condition in children has many causes, risk factors and symptoms. Diagnosis will require testing with follow-up treatment. There are also preventive measures that can be taken to reduce the risk of infection.

Symptoms

• TB Meningitis in children includes the following symptoms: fever; lethargy; and no desire for food; blackouts; queasiness or sickness; convulsions; photophobia (sensitivity to light); extreme headache; and sore or stiff neck. These symptoms typically are slow to develop. As with any condition, symptoms may present themselves at the same time or consecutively, and some symptoms may be absent.

Causes/Risk Factors

• TB Meningitis is caused by a bacterial infection associated with tuberculosis. The bacterium, called Mycobacterium tuberculosis, travels from another part of the body and infects the meninges of the brain.

  The disorder is rare in children. The risk factors that increase the chance of contracting it include: AIDS, overuse of alcohol, immune system compromised by other disorders, and pulmonary tuberculosis.

Tests for Diagnosis

• A spinal tap or lumbar puncture is performed on children whenever any type of meningitis is suspected. A portion of the fluid in the spine is withdrawn with a needle and sent to the laboratory for testing.

  TB meningitis can also diagnosed by taking a brain or meninges biopsy; a cerebrospinal fluid culture; strain; test for protein, glucose, and lymphocytes; polymerase chain reaction; or a skin test for TB otherwise known as a Purified Protein Derivative (PPD).

Treatment/Outlook/Complications

• TB meningitis is treated with a number of antitubercular drugs given concurrently. This treatment is similar to pulmonary tuberculosis. It will take about a year to complete the therapy and sometimes steroids are used as part of the treatment. TB meningitis can be fatal if left untreated. Continued follow-up after treatment will be necessary to prevent future outbreaks.

  This disorder can cause brain damage that may lead to abnormal behavior, mental impairment, fine and gross motor paralysis, and convulsions.

Prevention

• For very young children, the use of the Bacillus Calmette-Guerin (BCG), a TB vaccine, is used to help prevent this severe form of tuberculosis. Another effective treatment is use of the PPD test that will detect dormant and active forms of TB.